C946 Nursing Education Field Experience

Student Name

Leavitt School of Health, Western Governors University

C946 Nursing Education Field Experience

Instructor’s Name

Submission date

Executive Summary

The ADDIE model was adopted in solving the problem of the lack of early recognition and management of sepsis for the proposed sepsis module for Sage College Nursing Students.

Analysis Phase

Subsequently, the gaps that the detailed needs assessment showed to be significant in the nurses’ knowledge, clinical judgment, and timely intervention in sepsis were gaps that could lead to less positive patient outcomes (Khallaf et al., 2025). The current curriculum was found to be lacking in aspects of simulation learning and of early detection measures, which should be enhanced.

Design Phase

To ensure effective sepsis education, the mapping of course objectives, student learning outcomes and assessment strategies was incorporated into the design process. Two types of learning activities, which were designed to promote critical thinking and clinical decision making, were used: case-based learning and simulation.

Development Phase

During the development stage, evidence-based teaching resources, simulation situations, and formative and summative testing (Buléon et al., 2022) were developed. In the process of the development, the theory of the experiential learning model and constructivist learning model were used as a guide to promote learning activities and learning retention.

Implementation Phase

The implementation phase is a systematic way of implementing the module by trained faculty, providing resources, piloting before implementation and so on. Consistency and effectiveness in the implementation of courses are assured through faculty training and feedback mechanisms.

Evaluation Phase

The evaluation stage refers to the implementation of continuous quality improvement with the help of measuring the performance, assessment of students and assessment of the continuous course. This will help ensure that the module is effective, relevant and concurrent with best nursing practice.

Sepsis: Nurse’s Role

Sepsis is a life threatening syndrome that results from an extreme response of the body to an infection, resulting in generalised inflammation and organ failure. Can develop from a number of infections, can result in Septic Shock which can cause disruption of blood flow and organ failure in the body. It is vital to diagnose and treat at an early stage for a better chance of success for patients.

Sepsis is a big problem in terms of morbidity and mortality, and early detection and action is key. Nurses are on the front line in this and this module will aid in developing knowledge and skills in recognising and dealing with sepsis early. This module will be essential in training nurses to be able to manage sepsis, and enhance patients’ outcomes. This education must be invested in to increase the quality of care, and in turn, not only improve the battle against sepsis, but make it more successful.

Literature Review

Research Synthesis

The six peer-reviewed articles selected for this curriculum proposal provide a solid basis of evidence that the need exists to add more educational information about sepsis into the nursing curriculum, particularly through an interactive and simulation approach.

Connections between Similar Articles

The results have been consistent across studies, whether different or similar, that simulation-based learning is effective in enhancing the knowledge and skills on sepsis. A quasi-experimental study, conducted by Regina de Carvalho et al (2026) with 28 nurses, revealed that the use of high fidelity clinical simulation had a significant impact on clinical judgment (p value< 0.0001) and knowledge (p value< 0.0001). The post-simulation clinical judgement score of participants who actively participated in the simulation (34.5) was also found to be significantly higher than the post-simulation clinical judgement score of the observers (34.83) with a p value of 0.0252.

Rababa et al (2022) did a similar study on 70 nurses and found that branching simulation was effective in improving practices immediately (F=10.77 and P=0.002) and after two weeks (F=10.68 and P=0.002) and in improving decision making immediately (F=10.77 and P=0.002) and after two weeks (F=10.68 and P=0.002). Overall, the findings of the two demonstrate that interactive simulation-based approaches are much more effective in educating on sepsis than lecture-only approaches.

Both Cranston et al (2023) and Frank et al (2025) also emphasize the need for nurse-driven protocols and special sepsis coordinator positions to enhance the use of sepsis bundles. Cranston et al found that after introducing a sepsis coordinator position at Penn Medicine Lancaster General Hospital the compliance level to sepsis core measures rose by 40% over 4 years. Another important enabler for implementing sepsis bundles in EDs was nurse-driven protocols. All of this reveals a convergence towards the importance of providing new knowledge and support at a system level to enable nurses to deal with sepsis.

Dissimilar or Contradictory Findings

Much of the research literature is around acute emergency care and emergency departments; there are a few ways that this differs in terms of the provision of paediatric sepsis care. Anastasas et al. (2025) conducted a scoping review of post-sepsis care programs for children, and there is currently a great lack of structured and formally assessed models of providing paediatric post-sepsis care. Of 1843 records examined, only 8 met the inclusion criteria; in fact, only two unique models were identified, none of which were formally evaluated nor had measurable outcomes.

This shows that education and follow-up of patients with long-term management of sepsis is needed; currently, there appears to be a significant inequity in research conducted in the more acute care settings by others. In addition, Frank et al. (2025) found that multiple barriers to sepsis bundle implementation existed, such as alert fatigue, lack of staffing and a general disinclination to initiate the sepsis bundle. Conversely, Grootendorst et al. (2024) dealt with some of the positive outcome measures of the navigator position, giving little attention to these barriers. This difference indicates that the organisational setting and design of the job might have a significant impact on the effective delivery of sepsis interventions.

Findings that Support the Module Proposal

The six articles included in this paper will provide support for creating and implementing a proposed 1-week sepsis module. The first piece of evidence supporting the incorporation of high-fidelity scenario-based simulation as part of the module comes from the numerous studies that demonstrate the effectiveness of simulation-based learning. The second piece of evidence supports each intervention used in the module (case studies/simulation) as evidence-based because the studies conducted by Regina de Carvalho et al. (2026) and Rababa et al. (2022) revealed improvements in clinical judgement, decision making, and practice following education and training.

The third piece of evidence is provided by the studies of Cranston et al. (2023) and Frank et al. (2025) that outline nurse-driven protocols developed together with early recognition training, both of which are in alignment with the overall objectives of this module (timely identifying sepsis during screening and bundle interventions). The final piece of evidence relates to the barriers outlined in Frank et al. (2025) (e.g., staffing shortages/alert fatigue), which are examined more fully using force field analysis as well as in the implementation plans developed later in this proposal to ensure any potential barriers have been identified and planned for in an anticipatory manner.

Introduction to the ADDIE Model

The ADDIE model was applied in the development of this curriculum proposal. ADDIE stands for Analysis, Design, Development, Implementation and Evaluation — the five steps of instructional design. A systematic approach verifies the needs base, has objectives to guide curriculum development, is guided by evidence-based resources, and is continually assessed and enhanced.

Analysis Phase

The first step of the ADDIE model of instruction is the Analysis Phase. At this level, the instructional designer identifies the need or gap in the curriculum and conducts a needs assessment of learners, a review of the learning context and environment, and gathers all the information. The question of what is to be taught is answered in this phase. The Analysis Phase of this proposal will contain a description of the virtual academic setting, a curriculum need gap analysis table, a discussion of the curriculum as is and as envisioned, the analysis of organisational factors, and a force field analysis of the forces that will make the curriculum change easier and the forces that will make the change more difficult.

Design Phase

The Design Phase relates to planning to teach the curriculum. In this phase measurable course outcomes, measurable course objectives, and assessment strategies are written and the course syllabus is modified to accommodate the new module. The “how?” for teaching the content is met in this phase. The Design Phase for this proposal includes a revised course syllabus (Appendix A), analysis of course description and course objectives and student learning outcomes, and a description of how the grading policy is congruent with the course objectives.

Development Phase

The development phase is the phase of material development where the teaching and learning materials are created. During this phase, module content and materials, learning activities, formative and summative assessments are developed. This phase is trying to answer the question “what materials do we need for our teaching? The Development Phase comprises a proposed course module, evaluation, activities carried out to develop the course module, discussion of the learning theories that underlie the application of teaching strategies and resources, as well as discussion of support for the context-based scenario learning activity towards building students’ skills and students’ reflective practice in the context of the proposed course.

Implementation Phase

The Implementation Phase entails enacting the curriculum module here and now within the context of education. This period is related to the faculty training, provision of resources, pilot testing, feedback collection and the full-scale implementation of the module. This submission (Part 1) will not cover the Implementation Phase, as this is to be assessed through the capstone assessment (C947).

Evaluation Phase

Formative and summative evaluation of the curriculum is part of the Evaluation Phase. This phase includes performance measures, end-of-course surveys, ongoing quality improvement activities and data-based decision making to enhance the module over time. The Evaluation Phase will also be completed with C947, the capstone assessment (see template).

Virtual Academic Setting Description

The proposed module will be incorporated into the program of a Baccalaureate of Science in Nursing (BSN) at Sage College. Sage College is an academic institution that is delivered virtually and has a four-year BSN degree program accredited by various nursing accrediting bodies. The BSN program equips students with skills for professional practice in nursing, with an emphasis on evidence-based practice, thinking, leadership, and community health. The program has been designed to prepare the student to take the National Council Licensing Examination (NCLEX) for licensure as a competent generalist nurse to enter acute care, community health, and long-term care facilities.

Knowledge and Skills of the Typical Learner

The students in the proposed sepsis module will be a part of the NRS Contemporary Nursing Practice II course, which has a typical student population of second-year or third-year BSN students. These students have had the fundamental prerequisite courses: Anatomy & Physiology, Microbiology, Pathophysiology, Pharmacology, Health Assessment & Fundamentals of Nursing.

Learners need to have a basic understanding of infection/inflammation, but lack knowledge about recognising early signs of sepsis and management of septic shock. They undertake basic assessment skills, including taking basic life signs and physical examination skills. They should be guided in prioritising their multiple nursing interventions, timed sepsis bundles and effective communication with providers during critical times. The typical learner has an understanding of the basic concepts, but lacks the confidence and margin for error to be responsible for a deteriorating patient suspected of having sepsis.

Learning Environment and Instructional Delivery Methods

The course NRS Contemporary Nursing Practice II will be a hybrid learning environment (face-to-face and online learning activities). There are currently F2F sessions that include traditional interactive lectures, skills lab sessions (practice of clinical skills) and high fidelity simulation sessions at the college’s simulation facility. The vital signs and breath sounds, heart sounds, and other clinical findings can be illustrated in a realistic fashion with the manikins at the simulation centre.

Online learning: This is done through the college’s Learning Management System (LMS), where students read, see video lessons, participate in a discussion board, complete online learning modules that include knowledge checks, and submit assignments. Instructional delivery for the proposed sepsis module will consist of an interactive lecture with case examples, small group case study analysis, high fidelity simulation with structured de-briefing, online self-directed learning modules and online formative quiz with immediate feedback. This mix of teaching styles caters to a variety of learning styles and provides students with theoretical knowledge and learning through real-world application.

Current and Desired Curriculum Discussion

In the existing Sage College NRS Contemporary Nursing Practice II course, sepsis is a small sub-topic under the content area – systemic infection & inflammation. In particular, sepsis is mentioned in one 50-minute lecture, in the main thrust of the physiology of SIRS, as a manifestation of SIRS. The current curriculum summarises a brief description of the definition of sepsis, a general overview of infection as a source of inflammation, and a brief overview of the principles of treatment for infectious causes of inflammation such as antibiotics and supportive care. However, the curriculum does not focus on the education around a number of key areas of sepsis care. No teaching of how to use evidence-based early recognition tools, for example, the qSOFA score, National Early Warning Score (NEWS) or detailed SIRS with clinical application.

There is no description of the Surviving Sepsis Campaign Hour-1 Bundle, nor the 3 and 6 hour sepsis bundles, which are the standard of care in U.S. hospitals. Students are not taught about the use of lactate levels in the understanding of hypoperfusion associated with sepsis. Lacks of discussion on maintaining adequate fluid resuscitation and when to use vasopressor therapy. In addition, there are no prepared learning modules using simulation exercises regarding the management of sepsis, no case studies are available for students to identify sepsis based on clinical data, and there are no formal chances for students to practice their abilities of interdisciplinary communication in emergency situations with sepsis. Students read the required material in the textbook and attend the lecture without any hands-on or application – based learning about sepsis care.

The Desired State of the Curriculum

The desired state of curriculum is a program that leads to a nurse graduate who is confident and competent to identify signs and symptoms of sepsis and can, in a timely fashion, take evidence-based action. For this purpose, a particular One Week Module will be developed and incorporated into NRS Contemporary Nursing Practice II, specially focusing on recognition and management of sepsis. This module will give in-depth education on multiple areas of importance. Students will first be taught the entire pathophysiology of sepsis from infection to systemic inflammation to tissue hypoperfusion to organ dysfunction to septic shock.

Secondly, using case based practice, students will be able to learn how to apply validated screening tools, including qSOFA, NEWS and SIRS criteria. Thirdly, pupils will learn all aspects of the Surviving Sepsis Campaign Hour-1 Bundle: measuring lactate levels, blood cultures before antibiotics, broad-spectrum antibiotics and fluid resuscitation if the person is hypotensive or has a lactate level of 4 mmol/L or above. The fourth objective is for students to be able to describe the 3-hour and 6-hour sepsis bundles and the evidence supporting each bundle. Fifth, students will have an opportunity to communicate inter-disciplinarily with student peers using the SBAR tool, using the context of sepsis scenarios.

Finally, students will receive a training session using a high-fidelity simulation to practice their assessment of the septic patient, recognising abnormal parameters, calculating screening scores, and beginning components of the bundle and continuing their communication with the provider. Seventh, students will complete a formative quiz that will provide immediate feedback and alert students to learning gaps, and a summative objective assessment to demonstrate competency to move forward in the course.

The Identified Gap or Need in the Virtual Academic Setting

This module curriculum gap is identified as a lack of a focused comprehensive and simulation based sepsis education in the current Sage College NRS 212, Contemporary Nursing Practice II course. This deficiency manifests itself in three ways. Students only have limited knowledge on the main topic of sepsis – knowledge of the sepsis bundle is negligible as would be knowledge of evidence-based guidelines. Second, on the skill level, students don’t get to evaluate of sepsis, perform a sepsis bundle, or even even communicate with providers in a safe simulated environment.

Third, clinically, students do not practise any case based reasoning or prioritising with regard to the time-segmented view of sepsis care. This omission translates directly to lack of confidence and competence among nursing students to early recognize a sepsis patient and initiate appropriate life-saving interventions when they depart from the existing curriculum. This is a crucial patient safety and outcomes problem, with poor sepsis recognition and care resulting in increased morbidity and mortality.

Action Steps to Resolve the Gap and Achieve the Desired Curriculum State

Under the identified curricular gap, the proposed one week sepsis module will tackle this through a series of specific action steps targeting each part of the identified gap. First, to address the knowledge gap, the module includes extensive lecture content on sepsis pathophysiology, sepsis screening tools, sepsis bundle elements, fluid resuscitation, early antibiotic administration and interdisciplinary communication. Students will learn from their own chapter in a dedicated textbook, and from accesses to the Surviving Sepsis Campaign Hour-1 Bundle guidelines.

Second, to address the change in skills, the module allows for an experience in a simulated environment by allowing students to interact by actively managing a patient with suspected septic shock in a high fidelity scenario. In this simulation learners will assess the patient, calculate the qSOFA score, recognize abnormalities in vital signs and mental status, initiate the Hour-1 Bundle, and communicate with provider using SBAR. A structured de-briefing session, which provides feedback on how students have worked during the simulation, follows. Thirdly, to close this clinical judgment gap, the module features a section of case study analysis, where a student will analyze the patient data, prioritize the intervention and justify their clinical decision.

Fourthly, in the module, a 4-choice type question and answer exercise is prepared and given to students as a formative assessment activity to provide immediate feedback to improve learners’ accountability for learning and to know what they do not know before the summative assessment activity. Fifth, summative objective assessment is an assessment of the achievement of the learning outcomes, and its cut-off achievement score is at least eighty per cent.

Sixth, faculty will receive training in sepsis bundle protocols and in facilitation of the simulations to ensure that the modules are consistently and effectively delivered. Seventhly, the students will be divided into a small group and will be used as a pilot test, and the results of the test will be used to improve the modules. These action steps are so that you can approach each gap in a systematic manner, and focus the curriculum into the desired outcome of sepsis competent nursing graduates.

Organisational Factors Analysis

Two Internal Factors That May Support the Proposal

The proposal is supported by the first internal factor, which is the faculty expertise. Sage College has multiple Nurse Educators who have experience in critical care and emergency nursing. These faculty members have experience taking care of septic patients in practice and the knowledge and skills to be able to effectively implement the proposed sepsis module. Their know-how guarantees that students are educated by qualified teachers who will be able to offer pertinent clinical examples and respond to complex enquiries concerning the management of sepsis.

The second internal factor that supports the proposal is the already existing simulation lab. Sage College already has a high fidelity simulation lab equipped with all the equipment, manikins which can indicate vital signs, breath sounds and any other clinical data. An existing resource that can be used in the sepsis simulation scenario without the need to make a capital purchase for new equipment, making the proposal more feasible in terms of resources.

Two Internal Factors That May Limit the Proposal

The first is faculty workload, which is an internal constraint on the proposal. A new one week module in the course requires faculty time to prepare the module, simulate the course, mark the assessment, and feedback for the students. With all the other courses they teach and clinical supervision they already have, faculty members already have a heavy teaching load. The added time can lead to faculty-staff reluctance with regard to workload balancing. Another in-house limitation of the proposal is time allotment for the curriculum.

The current NRS Contemporary Nursing Practice II course has enough content that is difficult enough to master already, let alone master all of the content areas within one course, with one week left to finish. It takes a week to work out the details of the sepsis module, and for some, the shift involves either losing out on some content, or having to cut down on content; there is some resistance from faculty who like the content.

Two External Factors That May Support the Proposal

The external factor which is positive to the proposal is the national guidelines. The Surviving Sepsis Campaign, Centres for Medicare and Medicaid Services (CMS), and Joint Commission, to name a few in the healthcare environment, advocate for sepsis education and protocol utilisation, if not required, then strongly recommended. The external requirements are putting pressure on nursing programs to ensure that the graduating nurses are prepared to respond to the requirements, thereby bringing about the proposed module.

The second external factor in favor of the proposal is the healthcare employers’ demand. It’s revealed that local hospitals and health-care systems have reported new graduate nurses, especially, struggle with early recognition and taking appropriate action with regard to sepsis. Employers indicated that they desire nursing graduates to be more prepared to detect and treat Sepsis. This is an outside pressure which creates a strong external stimulus to change the curriculum.

Two External Factors That May Limit the Proposal

The first outside constraint on the proposal is cost. The implementation of the module can require extra funding for faculty to train for sepsis bundle updates, the cost of new materials to print, and the purchase of simulation materials. Because of institutional budget constraints, resources may be limited. An external constraint that exists against the proposal is the accreditation requirements. Any major change in the curriculum will be subject to review and approval by the appropriate nursing accreditation entity through each Sage College change. Some delay may be incurred in the implementation due to this approval process. Also, accreditation requirements could have additional requirements that must be satisfied before the module is accepted for inclusion in the curriculum.

Forces for the Curriculum Proposal

The first push, which will help to integrate the proposal, is the solid evidence from the literature on simulation-based Sepsis education. The findings of de Carvalho et al (2026) and Rababa et al (2022) suggest that simulation-based sepsis education impacts clinical judgment, knowledge and decision making of nursing students/registered nurses. This will be done through sharing this evidence with faculty and curriculum committees at proposal review meetings to give others a chance to leverage this force for creating a desired state for the curriculum. By showing that the proposed module is based on peer-reviewed high-quality research, it can be validated and allow the changes to the current curriculum.

The second factor that will enable the integration of the proposal is the already existing simulation lab and resources at Sage College. There is a high-fidelity simulation system in place at the college that could be utilised in the sepsis scenario, and no capital expenditure would be required for this scenario. To utilise this power, I’ll build the simulation so that it can be worked with in the existing setup. I will also demonstrate to the administration the capabilities of the module – that it can be easily adopted without a lot of additional expense, as the essential infrastructures are in place.

A third element that will aid the case for implementing is external pressure on healthcare employers on the necessity of better sepsis graduates. In local hospitals, new graduate nurses have been reported to lack the skills in identifying sepsis. In the proposal presentation, I’ll be placing emphasis on the feedback from the employer to the administration and curriculum committees, as this is how I plan to use this force. Signing up local employers who are requesting a need for improved sepsis education will provide a strong case for the module and aid in getting it approved and funded for implementation.

Forces against the Curriculum Proposal

One of the first obstacles to the proposal will be a shortage of time for faculty. Several course loads, clinical supervision, and involvement as a faculty member on various committees fill faculty teaching loads. This entails that considerable time and effort are needed for clinical teaching practice by nurse educators, and if there is an introduction of additional aspects of fertility in nursing education without reducing the time and energy spent on other aspects, nurse educators risk burnout and resentment (Gcawu and van Rooyen, 2022).

I’ll be providing ready-made lecture slides with complete lecture content, simulation scenarios (with facilitator guide), prewritten assessments and answer key, and detailed faculty instructions to help buffer the effects of this force. The module is more achievable even when workloads in the faculty are concerned, as it minimises what the faculty member needs to do, in terms of preparation time.

The second reason that will hinder the incorporation of the proposal is the limited time of the curriculum. Many areas of content within the current course, NRS Contemporary Nursing Practice II, have been covered, and the course is rather full with several areas of content that need to be covered within the limited weeks of the course. Frank et al (2025) found that one major implementation challenge reported for sepsis bundles – and one commonly reported challenge for curriculum implementation – was competing priorities.

Therefore, to help counter this ‘push’, I will be suggesting that, where possible, sepsis content is considered for inclusion, since older or redundant material no longer felt to be a high priority for the current evidence will be removed. Also, I will utilize an “flipped classroom” approach where students will be required to read and learn online at home, and then use class time for simulation and case-based learning exercises.

The third factor that will prevent the proposal from being integrated is possible budget limitations. While the simulation equipment is available at Sage College, a module may still require funding for faculty training on the updates to the sepsis bundle, costs for printing new materials for the module, and possibly costs for simulation supplies (intravenous supplies, medications used during the simulation, etc.). Resource limitations can impact the implementation of a curriculum, as Fuentes-Cimma et al (2024) said.

To mitigate the force of this, I will implement the following to be able to use existing simulation equipment with no need for new purchases, free online available resources such as SS Campaign guidelines, and apply for small internal grants/ departmental funding for minimal supplies. Furthermore, I will develop a budget justification process to demonstrate how the module will be done at a minimal cost and still have learning outcomes.

Design Phase

Course Description Analysis

The course description for NRS–Contemporary Nursing Practice II is: “NRS Contemporary Nursing Practice II is a lecture, discussion, online, standardised test, simulation, and clinical course focused on care of the client for the adult with complex health concerns.” Students will be actively engaged in the proposed sepsis module; the students will assess the manikin and make real-time clinical decisions in the proposed module and implement the Hour-1 Sepsis Bundle.

Case study discussions allow the learner to analyse the clinical data presented, and respond with explanations regarding his/her clinical reasoning, while built-in knowledge checks are included in the online modules where the learner must answer questions to progress in the module. In the case of simulation-based learning, it is an active learning that can’t be found in traditional lecture learning, as stated by Buléon et al (2022).

As one of the most common complex health issues encountered in a hospital context, the implications for students’ future professional practice as nurses are huge. At the end of this module, students should be able to recognise early signs of sepsis, screen for sepsis with scores (e.g., qSOFA), implement the Hour-1 Bundle, give antibiotics within the recommended time frame, and communicate effectively with providers via SBAR. They discovered that simulation was effective within Sepsis interprofessional education (IPE) to enhance the clinical practice outcomes.

This module will be useful to students in their future practice, as emphasised by Chua et al (2022). The course description was amended to include explicit wording of a specific focus on sepsis content in the current course description. The original description was for complex health problems in general, not the word ‘sepsis’. The proposed module will provide additional time and resources, but not the essential elements provided for the course description language, as sepsis will be one of the complex health issues addressed in the course.

Course Objectives Analysis

Two new Appendix A course objectives were created to address timely screening and bundling interventions within 3 hours of recognising sepsis and to effectively communicate across interdisciplinary teams within sepsis management scenarios.

Measurability of the Course Objectives

The first course objective is measurable (Observed) because students’ actual performance in the simulation activity indicates achievement of the first course objective. Faculty will be able to see students’ performance on upscreening of septic patients based on qSOFA;/c counselling students on blood culture, lactate ordering, antibiotic use, and fluid resuscitation. Multiple-choice and select all that apply items are also used to assess the knowledge needed to implement these interventions in the summative objective assessment.

The second course objective is expressed in terms of demonstrating, which can be measured by levels of performance with a common checklist or rubric. Faculty can determine if students apply the SBAR format appropriately, relay the information to be acted upon by the provider clearly, and provide specific recommendations to the provider. Chua et al (2022) showed that simulation-based assessment is a reliable tool to assess communication skills in the context of sepsis.

Alignment of Course Objectives with the Course

The two new course objectives directly relate to the current focus of the course, which is care of the adult client with complex health needs and the importance of care. Sepsis is a complex, time-critical situation which requires rapidity, proficiency and wisdom in assessing and prioritising multiple interventions. The first goal is one in which the course’s focus on timely assessments and interventions identified in the clinical course objectives are relevant. The second objective reminds and aligns with the course learning goal of effective communication with the client, family and members of the healthcare team. The 2 new objectives are included as part of the overall goal of the course and measurable skills in the course include sepsis.

Student Learning Outcome Analysis

The student learning outcome(s) developed for the proposed module are to analyze data from assessment to prioritize the interventions for sepsis for a patient with suspected septic shock.

Bloom’s Taxonomy Learning Domain for the Verb

The word in the sentence is in the cognitive domain and the analysis level of Bloom’s Taxonomy is analysis. At this grade, the students should be able to break the information down into parts and see how they are all interrelated and related to the whole. For this student learning outcome, students will have to identify multiple pieces of assessment data (vital signs, mental status findings, laboratory values, and physical assessment findings); determine those that indicate sepsis, and those that indicate septic shock; and determine what interventions are most urgent based on the relationship between the assessment findings.

Measurability of the Student Learning Outcome

This student learning outcome is measurable by the summative objective assessment (which has been developed in the module). These assessments consist of multiple-choice and select all that apply questions, which require students to make sense of hypotension, tachycardia, elevated lactate, mental status changes, etc., and then identify the priority interventions from a list. For instance, one of the assessment items may set the student a patient with fever, hypotension, tachycardia, tachypnea, confusion and a lactate of 4.2 mmol/L, and the student will be required to select the appropriate bundle to ‘activate’. An actual evaluation of student analysis of assessment data and prioritisation of interventions.

Alignment of the Student Learning Outcome with Course Objectives

This student learning outcome is directly related to the first of the course objectives: screening and bundle interventions are done within 3 hours of identifying sepsis. To execute, students need to first analyse the assessment data to enable them to execute the intervention based on the data. The second student learning outcome, the ability to communicate effectively amongst interdisciplinary team members across related disciplines during the process of managing sepsis, is indirectly addressed because the product of the analysis should result in the provider receiving communication via the SBAR format. As a consequence of the analysis, the content of classroom communication reflects this, and course goals and outcomes align and relate to learning.

Grading Policy Explanation

The proposed sepsis module will be split into two parts, which will be graded separately. The formative assessment will be a 10% of the module mark and will be judged on completion and not correctness. The summative objective assessment is for 90% of the module grade and is based on the number of correct answers. The pass mark for this module is 80%.

This is reflected in the policy of grading, in which the two course objectives asking the student to carry out the sepsis screening/bundle interventions within a suitable time frame and communicate effectively with other members of the interdisciplinary team can be tested through the summative assessment (90% of the module weight). The weighting of the assessment indicates the focus of the student towards priority learning outcomes, as mentioned by Elundu et al (2024). The formative assessment component (10% of the overall grade) is designed to allow students to attempt practice questions at no risk of marking; they will know which aspects of knowledge or understanding they lack before the summative component takes place.

A formative assessment with feedback is crucial to make students aware of what they need to learn more and decrease anxiety, as pointed out by Fuentes-Cimma et al (2024). The minimum passing percentage of 80% represents the standard of competency that is required for the nursing program and will ensure that the student has achieved an adequate standard of competency to meet the course objectives. The need for proper performance measures to ensure that the passing criteria reflect meaningful achievement of learning outcomes was discussed by Manheim (2023).

Development Phase

Course Module Creation Description

The proposed course module was developed based on the following procedure. The first step was to complete a needs assessment of the current course of the NRS Contemporary Nursing Practice II course at Sage College and identify the gap in the education of sepsis. This was followed by a review of six peer-reviewed articles published within the last five years in light of their use of evidence to support teaching strategies presented in the field of sepsis education, including articles by Regina de Carvalho et al (2026), Rababa et al (2022) and Frank et al (2025).

The next step in the development process was to select an instructional design model that would serve as a framework for the process. The model selected was ADDIE. The fourth step was to develop student learning outcomes and course objectives in measurable terms using Bloom’s taxonomy, which featured measurable verbs in every outcome. The fifth step was the selection of teaching methods that would be used in this study, including interactive lecture, case study analysis, and high-fidelity simulation, which were discussed in the literature review. Identification of learning resources was the sixth step and comprised the core textbook and two further resources—the Surviving Sepsis Campaign guidelines and an online module.

Step 7 involved creating a context-based simulation scenario for the students to assess a septic shock patient and initiate the Hour-1 Bundle. It has been proven that simulation-based training enhances clinical skills, which has been validated by Elundu et al (2024) when the simulation was developed using systematic steps. The eighth section was dedicated to the design of a formative assessment, based on 5 multiple-choice questions and a so-called ‘solution file’ of the assessment, providing instant feedback regarding every answer. A summative objective assessment that includes two types of items (MSQ & SAT), 10 items was constructed (Step 9). The tenth step was an evaluation of all of the materials against the goals and learning outcomes for the course, with revisions made in accordance with the ideas offered by faculty reviewers.

Current Learning Theories Description

This module uses high-fidelity simulation, case studies and interactive lectures as teaching strategies. These strategies are formulated in relation to the theory of learning, which is based on experiential learning theory, in which the learner is an active learner who generates from their own experiences and reflects upon them. The simulation activity provides students with an opportunity to develop knowledge as they take on the role of a nurse managing a septic patient, making decisions, and seeing how these decisions impact their patients. The case study provides a real-life use of prior knowledge in a fresh context. Stenseth et al (2022) also demonstrated that the use of technology to enable simulation-based learning promotes critical thinking in nursing students by giving them opportunities to learn in an experiential manner.

The learning resources in Appendix B are evidence-based learning resources. To facilitate students’ learning, Urden, Stacy, and Lough’s (2023) textbook offers organised evidence-based content that the students can read, review, and refer to, thus supporting knowledge acquisition. The Surviving Sepsis Campaign (2024) guidelines are a practical resource for students to use when working in clinical practice to make the link from the classroom to the clinical setting. The online sepsis module at the Society of Critical Care Medicine in 2024 has provided a platform for students to learn at their own pace, review difficult concepts and get access to various resources anytime. Elundu et al (2024) recommended that employing multiple learning materials has the capability to address various learning preferences and enhance knowledge retention.

Context-Based Scenario Learning Activity

This activity will help students to practice their detecting skills for Abnormal vital signs: hypotension: 88/52, tachycardia: 118, tachypnea: 28 and fever: 39.2 degrees Celsius. Additionally, students should know of a change of mental state as stated by the family. Students then work out the qSOFA score (3 out of 3) using the following: Altered mental status, respiratory rate >/= 22, and systolic blood pressure </= 100. After this analysis, students must then trigger the three-hour sepsis bundle, with Lactate, Blood Cultures before Antibiotics, Broad Spectrum Antibiotics and Fluid Resuscitation (30ml/kg crystalloid).

There will also be a simulated physician who will need to interface with the students using the SBAR format. These activities develop clinical reasoning, prioritising, psychomotor skills and interdisciplinary communication. Rababa et al (2022) demonstrated that there is a strong impact of simulation-based scenarios on improving clinical decision-making and practice skills of nurses. For this simulation activity, there is evidence coming from the Surviving Sepsis Campaign (2024) guidelines: The Hour-1 Bundle should be done within 1 hour of sepsis recognition.

This activity affords an opportunity for reflective practice because there is a structured debriefing after the simulation. Learners debrief to discuss what they have done, what has gone well, what they would do differently and how this relates to the Surviving Sepsis Campaign (2024) evidence-based guidelines. Regina de Carvalho et al (2026) identified that de-briefing following simulation has a great impact on clinical judgment and self-efficacy. This reflection will then inspire further learning and awareness, with the students taking on the right approach to manage sepsis for their future practice.

Formative Assessment Description

There is a 5-question formative quiz before students are subjected to a summative assessment to test their knowledge about the key principles of sepsis, including the concept of recognition, bundles, interpretation of lactate, timing of starting antibiotics and ‘SBAR’ communication. It will make the students realise their knowledge and ignorance about it and thus study accordingly. This was corroborated by Fuentes-Cimma et al (2024), who discovered that formative assessment is beneficial for students, knowing where they stand, and should be implemented in a way that encourages learning.

Feedback after each question – Immediate feedback is provided after each question (Correct/Incorrect), and a correct answer with a brief explanation is provided. That is, if the student gets the first question wrong, the feedback is: “Incorrect.” Early intervention with the Hour-1 Sepsis Bundle is key, as this is shown to reduce mortality. Some other action might be considered, but it is not of first priority.

Feedback is provided that shows whether the responses are right or wrong in relation to evidence based guideline. In Question 2, if the student selects vasopressors as part of the Hour-1 Bundle, the feedback states: Inadequate. The Surviving Sepsis Campaign (2024) does not provide details on using vasopressors as part of the Hour-1 Bundle, but recommends that they should be considered in refractory shock following appropriate fluid resuscitation.

Students are provided feedback and are supported to recognise any areas for improvement from the assessment. If pupils miss questions about sepsis bundles, they know that they need to relook. Students know to review tissue hypoperfusion indicators for questions on lactate. Students understand that if they don’t answer antibiotic timing questions, then they should refer to the Surviving Sepsis Campaign (2024) Guidelines. Specific feedback is targeted, supports study and is for summative assessment.

Summative Assessment Analysis (Objective or Performance)

The objective assessment results can be used to enhance teaching and student learning through analysis of the most frequent student mistakes on the objective assessment’s questions. If a significant proportion of students are falling short in the Sepsis bundle (as indicated in the question), the instructor will be aware and allow more time in the next delivery of the module for the student to learn the elements of the Sepsis bundle. If students are having problems with the interpretation of the lactate results in Questions 2 and 3, more examples/case questions will be added to the module. If the students’ performances in achievement for Question 8 communication about SBAR are not good, the lecturer will improve the education of skills to communicate interdisciplinarily. Buléon et al (2022) stated that Objective Assessment Data can be used to give feedback to improve instruction if it is analysed systematically.

Several methods of interpreting assessment outcomes, such as item difficulty, item discrimination, and test level reliability, are used. The p-value or item difficulty is the percentage of students who answered each question correctly; the desired value is between 0.30 and 0.90 for the percentage of students who answered each question correctly. Generally, scores less than 0.30 are considered too hard, and scores greater than 0.90 are considered too easy.

ITEM DISCRIMINATION compares the high-scoring students with the low-scoring students on each item, and values > 0.20 are acceptable, and values > 0.40 are excellent. The Kuder-Richardson Formula 20 (KR-20) will be used to calculate the internal consistency of the assessment (test level reliability). Note: KR-20 can be above 0.70 and be acceptable in a classroom assessment. Elundu et al (2024) mentioned that such applications of statistical methods are invaluable to establish the quality of assessment in the education of nurses.

Data analysis short term recommendation for improvement: Review all concepts that fall below 0.30, reteach those concepts during the next passing of this module and make supplemental learning materials available for students who are having difficulty with the concepts. The teacher will look at the wording of items with low discrimination and consider revising these items.

Long-term are to change or replace low performing across cohorts items of low difficulty and/or low discrimination. Those student errors will be used as the basis for making changes in the teaching strategies through pattern analysis. Cohort performance over time will be analysed for module effectiveness and trends. As they measured and continuously analysed the data and made adjustments over time, taking into account the performance data, this led to improvements in learning outcomes, according to Manheim (2023).

Table 3: Timeline Table or Gantt Chart  

Week	Activity	Phase	Responsible Person
Week 1	Faculty training and resource preparation	Implementation	Nurse Educator & IT Specialist
Week 2	Pilot testing with selected students	Implementation	Course Faculty
Week 3	Feedback collection (surveys, peer review, simulations)	Implementation	Faculty & Students
Week 4	Content revision and improvement	Implementation	Curriculum Team
Week 5	Full module implementation	Implementation	Faculty
Week 6	Post-test, survey, and performance evaluation	Evaluation	Faculty & Program Coordinator

Implementation Phase

Implementation Plan

The proposed sepsis module will be rolled out in Sage College in 6 weeks for the NRS Contemporary Nursing Practice II course. Students in nursing schools and registered nurses will be led by experienced critical care and nursing education teachers for two hours a week.

Resources Needed

Implementation of the curriculum requires gathering and utilization of appropriate resources in the form of human, financial, and technological resources to ensure that the curriculum can be delivered effectively, so that learning can be carried out as well.

Human Resources

• Nurse educator who has experience in sepsis management.
• IT-support specialist on LMS and simulation set-up.

The nurse educator will make sure that the evidence-based content is delivered correctly and students are guided to develop the clinical decision-making skills (Gcawu & Rooyen, 2022). The IT specialist will provide support for technology integration and ensure the online learning and simulation platforms function well.

Financial Resource

• A budget will be made available for Simulation tools, Faculty Trainings, and Instructional Materials.

Adequate financial support will enable access to good simulation equipment and will help in the overall learning process (Elendu et al., 2024).

Technology Resource

• Learning Management System (LMS) and high-fidelity simulation equipment.
• The use of technology and interactive learning helps students apply theoretical knowledge in a simulated clinical setting (Stenseth et al., 2022).
• A process for collecting feedback is in place.

Data should be collected before the entire curriculum is implemented, and this is needed to pinpoint those gaps and to improve the effectiveness of the curriculum.

The pilot phase (Week 2-3) will collect feedback by means of:

• Student surveys
• Faculty peer review
• Simulation performance evaluation

Impact of Feedback

At the initial stages, giving feedback will allow revising the contents, teaching strategies, and interaction with students in time, improving the clarity of all these elements (Fuentes-Cimma et al., 2024). Feedback analysis helps identify such factors as difficulty of content, omissions in content delivery, and effectiveness of teaching strategies.

Based on feedback

• The material will be updated.
• The teaching strategies will be altered.
• The simulation scenarios will be narrowed down.

Faculty Training Plan

• The training of the faculty is a prerequisite for being consistent and effective in the execution of the curriculum.

Training will include

• Sepsis guidelines workshop and sepsis bundle protocol workshop.
• Simulation-based teaching training
• Content delivery training on LMS

Faculty training would ensure that everyone is teaching in the same way, reduce the variance in the teaching of the module, and lead to successful implementation.

Evaluation Phase

Performance Metrics

Performance measures give quantifiable measures of how successful and effective the curriculum is.

KPI 1

• Student pass rate (Benchmark: ≥ 85)

KPI 2

• Student satisfaction score (Benchmark: ≥ 90%)

Purpose

The selected benchmarks aim to reflect satisfactory standards of achievement and satisfaction in the learning process in nursing education. Performance metrics can be used to determine strengths and weaknesses in the course, and based on the data, make an informed decision on how to improve the course (Manheim, 2023).

End-of-Course Survey

An end-of-course survey is a very much-needed tool in assessing student experiences and course effectiveness.

Purpose

• Assess clarity of course content
• Evaluate teaching effectiveness
• Assess student satisfaction in general.

Course Changes

Survey information is utilized to inform the curriculum process and to ensure that the curriculum is designed to meet the students’ needs.

Examples of feedback

• Poor interpretation of the lab values of sepsis.
• Need for more simulation sessions.
• Pace/workload issues.

Based on this feedback

• Material can be reduced.
• The time of simulation can be extended.
• Pacing of the course can be changed.

Continuous Evaluation

Constant assessment will help to keep the course in touch with the needs of students and teachers during the course delivery.

Methods include

• Weekly formative assessments
• Real-time feedback sessions
• Reflective and adjustment of the instructor.

Continuous assessment allows the teacher to make changes to the teaching strategies, which will be instantly implemented to improve students’ learning.

Conclusion

The proposed sepsis module provides an important resource for nursing education and increases knowledge, clinical competence, and decision-making related to the management of sepsis . In addition, the curriculum facilitators will provide the necessary knowledge and skills required for early detection and intervention with the goal of decreasing morbidity and mortality for patients diagnosed with this condition. With the use of evidence-based practices, simulation-based learning, and inter-professional collaboration, nursing education can also be improved considerably.

The additional resource may ultimately benefit nursing students’ competency, faculty effectiveness, and curriculum quality while improving patient outcomes and promoting nursing as a profession by increasing critical thinking skills and clinical skill levels. The curriculum is designed to appeal to many different learning preferences through a variety of academic pedagogies such as visual, auditory, and experiential methods. Additionally, as the curriculum will enable nurses to demonstrate the requisite competencies and skills for safe and effective patient care, it aligns with the goals of nursing education as a whole. Ultimately, the proposed curriculum will benefit notified patients upon release from a health care facility as well as enhance professional practices.

References

Anastasas, K., Bale, T., Blyth, C., Gill, F., Hanham, A., Harvey, J., Kenworthy, A., Martin, A., McCarthy, B., Middleton, N., O’Conner, L., Paterson, Z., Pienaar, C., Rice, E., Robinson, M., Slack, S., Stowe, J., Wakeling, T., White, J., … Blyth, C. C. (2025). Emerging elements of paediatric post-sepsis care programs: A scoping review. Australian Critical Care, 38(6). https://doi.org/10.1016/j.aucc.2025.101316

Elendu, C., Amaechi, D. C., Okatta, A. U., Amaechi, E. C., Elendu, T. C., Ezeh, C. P., & Elendu, I. D. (2024).  Medicine, 103(27), 1–14. https://doi.org/10.1097/MD.0000000000038813

Frank, H. E., Sarani, N., Hayes, J. F., Martinez, R. G., Goldstein, J., Evans, L., Phillips, G., Dellinger, R. P., Portelli, D., Schorr, C., Terry, K. M., Harmon, L., Townsend, S., & Levy, M. M. (2025). Annals of Emergency Medicine, 86(3), 264–274. https://doi.org/10.1016/j.annemergmed.2025.04.005

Grootendorst, M. A., Bilyeu, T. E., Harris, L. A., & Kreiser, J. B. (2024). Sepsis navigators and hospital outcomes: This nursing role supports sepsis protocol improvements. American Nurse Journal, 19(1), 42–48. https://doi.org/10.51256/ANJ012442

Regina-de-Carvalho, L., Marcondes-Westin, U., Elizabete-Pagotti-da-Fonseca, R., Bressani-Lino, R., Victorino, J. P., & Helena-Zem-Mascarenhas, S. (2026). Clinical judgment and self-efficacy of nurses in sepsis management: The use of clinical simulation. Enfermería Intensiva, 37(1). https://doi.org/10.1016/j.enfi.2025.500577

Society of Critical Care Medicine. (2024). Sepsis education module [Online learning platform]. Surviving Sepsis Campaign. (2024). *Hour-1 Bundle of Care*. https://www.survivingsepsis.org